The unfinished stays with us within us, nagging at us in different ways at different times, sometimes with considerable creativity, sometimes just as a subliminal itch.

More than twenty-five years ago a patient came to see me with complaints that were in no way out of the ordinary. You will see as we go along that there is no way that I could violate his privacy rights by writing about him. He complained of being ill used at work, unappreciated at home. He wondered why it was his lot always to have to hold up under such a load. There were tinges of depression, even tinges of suicidality. I remarked that he maintained a peculiar subtle distance from all that he said, as if he were talking not quite about himself, yet not quite about someone else. In the fifth session, I had the sense of him fading out just a bit more, so that it was not exactly a surprise to me when he did not come for he sixth session.

He did not come and he did not call. I was concerned about him, puzzled about what had occurred in him, what had taken place between the two of us. I waited a week and then started actively to search for news of him. I called the phone number he had given as his home number. The person who answered the phone said she had never heard of any such person, that it was certain that no such person lived at this address. I called the number he had given as his work number. The person who answered the phone said he had never heard of any such person, but perhaps I should call the personnel people, whose extension he very courteously provided me. The woman in personnel was polite and then, after a few minutes of investigation, firm when she said no such person had ever worked for this large company. I asked if it might be possible that they had lost someone. She assured me that they kept very careful records.

I looked in the telephone book. I considered calling social security to see what they could tell me about the person attached to the collection of digits on the form I had in my hand. I realized that social security, in all probability, would refuse to tell me anything at all. What was on the form was, quite likely, just an invented set of digits crafted to look like a social security number.

So I was left with nothing at all. It has continued just that way until this very day. Needless to say, I did not get paid. I had no way to contact him. I had no no way to send out a bill. I was left with the astonishing idea that this man had made himself up in order to go tell a psychiatrist about his troubles which were some amalgam of real and imaginary, the precise proportion of each lying well beyond the bounds of specification. I had no inkling that he was psychotic. Was he dissociative? I had no way productively to touch this question. He was fictional, but very real. He had been in my office, shared space and air with me, even smiled shyly two or three times. He had simultaneously sought human contact and avoided it. His was an extreme instance of the injunction, “Hug me but don’t touch me.”

He has stayed with me over the years. I have told the story more than once to colleagues, friends, residents, framing it as an open ended riddle, any answer to which would necessarily be fictional. I have wondered about the varying extents to which patients make themselves up simultaneously to seek and avoid treatment and also about the varying extents to which psychiatrists and psychotherapists make themselves up in order to provide and to avoid providing treatment. The so-called real and the so-called fictional have complex and shifting boundaries, perhaps so complex and so unstable that they can not be specified. This is not a new frontier but rather a very old frontier.

“I think I’ve missed most of my life...”
“Say more.”
“I’m not who I meant to be, not that I meant to be anyone. I don’t feel I was meant to be who I am or how I am. I think my mother and father would recognize me, if they saw me now. But when I look in the mirror, that person doesn’t seem like me. There is a certain familiarity, but that familiarity is neither intimacy nor accord. It’s a stand off between myself and the one whom I see in the mirror.”
“Go on.”
“I wonder how this happened. Did I just take my parents’ word for who I was? If we could exhume them from the yellow midwestern clay where they lie next to each other, my parents would protest that they never had any blueprint for me, that they just wanted me to be happy. The sad thing is that that’s just what I would say to my own kids, if I were pressed. But I don’t go into this sort of thing with my children any more than I went into it with my parents. For a long time I didn’t go into it with myself. I suppose you could say that a certain brand of privacy, maybe even isolation is a tradition in my family.”
“Mmmm.”
“I’m fifty-eight years old. I have enough money. I have a stable marriage and three grown children. It’s not that I dislike my life. It’s a fine life, but it doesn’t fit. It would be a wonderful life for someone else. Over the last two years, a very strange thing has been happening. I know the past is gone, but it has been coming more and more alive in my mind. It’s more alive now than it was when it was present. I don’t understand how or why this has been happening, but it’s fascinating. And crushing, too.
“How so?”
“I notice hints, promptings, possibilities. Light shines where it never did before. I see an expression on a woman’s face. I see an older man’s raised wild eyebrow. I see a bill announcing who is playing at a jazz club. I see a sign pointing the way to the zoo. I see the cover of a novel. I see a ship pulling out of the harbor stacked with containers and I realize I could have gone where it was going. I missed all this when it was happening. It’s not that I made a wrong turn. I didn’t notice the turns that I could have made. I was not lost. I was too wooden. I just didn’t feel my life as living. So it’s crushing now when I realize just how alive it was, just how alive I could have been. I realize something else than what I have lived was beckoning to me all the time. I blame myself for murdering my own life bit by bit, secretly, unobtrusively. People speak of lack of imagination without any sense of how large a lack that can be. When they speak of lack of imagination this way, they are demonstrating just what they mean to describe without any awareness. My own life is so full of ironies.”
“Ummhgg.”
“I always thought of myself as a dull person and congratulated myself on my dullness. I suppose I believe it conferred an immunity, really an immunity with quite a broad range. I might as well say that I believed it conferred a superiority on me. I was not at risk. I was above risk. The irony is that now it seems to me not that I was above risk, but that I was below risk. I wasn’t venturesome. Now in my mind I have a terrible hunger to venture. You might say that I have a terrible hunger for adventure. Nothing ventured, nothing gained. I used to feel that it was nothing ventured, nothing lost. So I was mummified, dead in life because I was dead to life.”
“Ooof.”
“All this was without words. It had to be without words because it was without thought,
without feeling. It was an inner totalitarianism that shut out all but the narrowest sliver of life. It shut out any liveliness. In the last two years everything has changed, but in a private way.
“And so you’ve come here?”
“Only because I had no idea what else to do. Actually, it was a whim. I couldn’t talk to my wife about this, or my children, or my friends. They wouldn’t know who was talking to them. That’s how far this is from the one I’ve impersonated. Am I crazy? I might well be, but so very quietly... "

I'm talking with an elderly man who has always been a physical risk taker, so extremely much so that he is convinced that it is genetic and that he has the gene or genes for this kind of behavior. This risk-taking has led to great accomplishments but also to innumerable injuries, both more and less dreadful, some with irreversible and dire consequences.

"I'm still a risk-taker," he says. Together we get to the idea that both thinking and feeling are risk taking activities that many people avoid because they represent threats to their senses of stability and security. If you think, if you feel, you may not turn out to be quite who you took yourself to be. If you think, if you feel, the world around you, including those nearest and dearest, may turn out to be different than you thought. You can sustain thought and feeling injuries that can be as crippling as physical injuries.

Of course, if you do not think and feel, as if you do not move, there are opportunity costs. You lose out on opportunities that may heal and help, even inspire, as well as on those that may hurt. Opportunity costs are extremely hard to characterize, because
this side of realization opportunities are by definition imponderable. To live with an open horizon is not simple, but is a fundamental freedom.

Until this conversation, I had not thought to put mental daring next to physical daring.
The two are clearly different, but also share basic features. Security and curiosity meld
to make daring possible both in the physical realm and in the mental realm. I got great pleasure from this conversation because not only did it enrich my understanding of this man, but it provided me with a new light to shine on myself in myself. I'm still an explorer without a finished map.

“This is not how I drew it up. This is not what the blueprints said. I really don’t know what it is. If it’s my life, I really don’t want it, but I have kids to think about, so that’s why I’m still here. I’m going to go on being here, too. I wonder if I’ll ever get used to myself. I hardly can remember what used to be but I can’t forget it either.”

“I feel like I got lost and wandered in to someone else’s life. If they want it back, they sure can have it. I feel like an immigrant. I haven’t learned the language and I don’t really want to learn it.”

“I don’t know how I got here. I suppose one thing led to another, but I never had any idea of the destination. I was kind of just along for the ride. I’ve turned in to someone I hardly recognize. The particulars of my life shock me when I stop to consider them, which is why I try not to, which is why I don’t understand what I’m doing here talking with you.”

“I don’t like Kafka, but the reason I don’t like him is that he knows too much. He’s too close to truth that is beyond inconvenient. You really can wake up in the morning to discover you have been turned into a huge bug. Some mischief in the night. An accident. Nobody meant you any harm. But how do you learn to live like a bug? And even Kafka is still being polite, because you can be turned into something even stranger than a bug while you go on looking just like yourself.”

“The palm reader told me that I was going to live to 101. I wanted to smack her. She thought it was a good fortune, but I didn’t. I was sorry I ever went to see her. 101 is just too long, especially alone. Not that I ever meant to be alone like this.”

“It’s like you’re on a train and the train is going down the track and then, without any warning, the train hits a switch that someone has thrown and now you’re on another track that’s going to take you somewhere new. It’s spooky. You don’t know where you’re going and you didn’t buy a ticket, but there’s no way to get off the train.”

I sit and I listen to people. This is what I do for a living. I consider it remarkable that life has been so kind to me as to allow me to do something for a living that I enjoy. I am comfortable with the life I am lucky enough to lead now. It suits me as I currently know myself. I can recall times in my life when my circumstances seemed strange, alien, imposing, so when I listen to people in their forties and fifties, most of whom have suffered a devastating loss , expressing their discomfort in their lives, I resonate. The uncanny is a real and painful part of life. How do we settle in a strange place? How do we settle when we have become strangers to ourselves?

She is telling a story as she has been telling a story for years — this imaginary person, this imaginary patient. This story is not one story but many stories nesting in each other, sometimes bursting into flight to land somewhere else and make a new beginning. She is a reliably unreliable narrator. It is not even clear when she plots beforehand, when she does not, when she is speaking for calculated effect, when she is speaking because she can not help herself, can not any more impede the rush of words from her mouth, She is present at once so carefully and also so self-indulgently. There are so many of her and and this crowd is not even one.

I am listening to her story as I have been for years — this imaginary person, this imaginary doctor. I am listening to her and I am making it up as she goes along. I am breaking it into pieces as she goes along. I am elaborating these pieces as they wake me up and develop fingers of dream that reach from her into me and touch me not in one way but in many ways. Listening to her is a kind of ecstasy that almost lets me stand outside myself except that I keep tripping on the threshold.

As she is a reliably unreliable narrator, I am a multiply and extravagantly unreliable curator of her story, not from malice, but out of that most peculiar hope of helping. This hope is imbued with pride and shame, the two sides of an exquisite fabric. Look at this side and it is pride. Flip it over and look from the other side and it is shame. Is there a way to see both sides at once? Possibly it can be done with internal mirrors, a fracture of points of view in the name of something like a higher degree of integration, but it’s always a good idea to be careful about altitude and attitude,

I discern a theme – or believe that I discern a theme – in the extravagant and unstable multiplicity of the story that she has been telling me for years that takes place on four different continents. This theme is her own insignificance, how little she matters, how in the scales of life she is held almost as nothing, asymptotically approaching zero. Yet this is the most significant of insignificances to which nothing else can actually compare.

This insignificance is her most precious possession. It possesses her in ways that are at once lavish and intimate, so intimate as to be next to unspeakable, ravishing, even obscene. It is this radical insignificance that licenses her demands, that lets her want so desperately and so defiantly and so much. It is this radical insignificance that lets her live wild outside of the fenced territory of satisfaction. It is this radical insignificance become hunger that lets her hunt and kill with only a thrill and no remorse. She stops herself only at the greatest cost and for reasons that are totally obscure to her,

This is only the beginning, or should I say more properly only a beginning, one thread among many that might be chosen, pulled out to glint in the sunlight. The going on is not simple and perhaps only a pretense, a simplification so extreme as to take the breath away. This is not to say that I have not gone on at great length in my mind. I have gone on at great length in many different directions, letting the roads unravel off the spool and seek distant cities, distant climes, distant wilderness.

The problem though is that my tongue is tied. She has tied my tongue in knots, deft and difficult knots, of which her surgeon father would have been proud could he only have found a way to travel in realms this abstract. I am forbidden to speak. I am allowed to know or to think I know, but forbidden to speak what I know, forbidden more strictly in proportion as I believe that what I have heard from her and what I have come to believe I know might be helpful to her. I pass some of the time wondering if she knows that she ties my tongue and glories in how adept she is at these knots. Or is she ignorant of the fact that she ties my tongue in knots and glories yet in the fact of the tying which she can not explain?

Sometimes I go so far as to flatter myself in this predicament with a thought that seems clever to me —hard as it may be to tell truth to power, it is possibly even harder to tell truth to powerlessness. But this only passes the time. She is talking and sitting there and looking at me and wanting something which, even if I could give it, she could not take because it would threaten to abolish her as she knows herself. The sun is coming in the window and I can see a few clouds sailing through the sky. She is telling me about yet another disappointment and I dare think I know that it is I who am disappointing. I don’t say anything because as her dearest friend and nearest enemy I have no right to deny her the satisfaction of disappointment.

Can I discern something of the impetus to write that gives rise to this? I speak with myself because I can not speak with her and yet I am with her in my speaking to myself. It is not only a portion of my soul that has come to be ingrown but also a portion of hers with it. Her telling of her story – to which she does not like to listen – and my hearing it and retelling it and turning into something counterfeit mixed with me has begun to spawn and to seed at a distance, to set forth into the world without either the need or the capability to declare its origins. It tends not only to the unknown but beyond to the unknowable.